University of Rochester, Rochester, New York, USA.
Int J Oral Maxillofac Implants. 2011 May-Jun;26(3):593-7.
The present paper demonstrates a new technique and long-term results of a treatment concept that uses four implants placed in the anterior mandible that are connected to prefabricated telescopic abutments and immediately loaded with removable restorations.
The present retrospective study included 488 implants (Ankylos, Dentsply) placed in 122 patients (mean age: 65.2 ± 9.8 years) with clinical and radiographic evaluation for a period of at least 1 year. Eighty-four implants were placed in fresh extraction sockets and combined in the restorations with implants placed in healed ridges. All implants were placed 2 mm subcrestally (based on chart documentation, measured from the midfacial bone level). The implants were connected immediately after surgery to conical prefabricated abutments (angle of 4 to 6 degrees) using a final torque of 15 Ncm. Secondary prefabricated copings that fit the abutments were placed over the abutments after abutment connection, and the complete denture of each patient was relined chairside with methyl methacrylate resin. The prosthetic restorations were to remain in place for 10 days to ensure that the implants remained immobile.
After a mean of 79 ± 29.8 months (range, 17 to 129 months) only eight implants failed (1.6%). Twenty-one implants (4.3%) showed crestal bone loss greater than 2 mm relative to the implant position at the time of implant insertion. Therefore, the failure rate was 5.94% for the entire observation period. The success rate for the evaluated implants was 94.06%. The patients were satisfied with the stability of their prostheses, and no prosthetic or peri-implant problems were observed.
These telescopic implant-supported restorations with immediate loading seem to be an alternative prosthetic solution for the edentulous patient, providing long-term implant stability.
本论文展示了一种新的技术和治疗理念的长期结果，该理念使用四颗种植体置于下颌前牙区，这些种植体与预制的伸缩式基台相连，并立即使用可摘义齿修复体负重。
本回顾性研究纳入了 122 名患者（平均年龄：65.2 ± 9.8 岁）的 488 枚种植体（Ankylos，Dentsply），这些患者的临床和影像学评估时间至少为 1 年。84 枚种植体被置于新鲜拔牙窝内，并与愈合牙槽嵴内的种植体在修复体中组合。所有种植体均置于骨嵴下 2mm 处（基于图表记录，从面中部骨水平测量）。种植体在手术后立即与锥形预制基台（角度为 4 至 6 度）连接，使用 15 Ncm 的最终扭矩。在基台连接后，将适配基台的二级预制外冠放置在基台上，然后每位患者的全口义齿在椅旁用甲基丙烯酸甲酯树脂重新衬里。修复体需要保持就位 10 天，以确保种植体保持稳定。
在平均 79 ± 29.8 个月（范围 17 至 129 个月）后，只有 8 枚种植体失败（1.6%）。21 枚种植体（4.3%）出现相对于种植体植入时位置的牙槽嵴骨丧失大于 2mm。因此，整个观察期的失败率为 5.94%。评估种植体的成功率为 94.06%。患者对其义齿的稳定性满意，未观察到任何修复体或种植体周围问题。
这些带有即刻负重的伸缩式种植体支持修复体似乎是无牙颌患者的一种替代修复方案，可提供长期种植体稳定性。
